This transcript documents the gross pathology examination of a complex skin and soft tissue surgical specimen, measuring 7.8 x 3.9 cm, featuring a central 6.3 x 2.5 cm tan pink-to-red, poorly demarcated, ulcerative lesion. The specimen was oriented using superior (12:00, short stitch) and medial (9:00, long stitch) markers. Initial measurements confirmed margin clearances ranging from 0.5 cm (medial) to 0.8 cm (superior). The deep aspect, which included moderate amounts of muscle and fascia, was inked orange, with other margins inked blue (12:00) and black (6:00). Sequential radial margins were removed for separate histological submission. Serial sectioning revealed a tan-yellow granular cut surface extending to the underlying muscle and subcutaneous fat layers, with the granular tissue remaining 0.6 cm from the closest deep resection margin. A detailed submission protocol (B1-B16) was established for subsequent microscopic analysis.
Gross Examination of Surgical Specimen: Dimensions, Margins, and Submission
0:00:15 Specimen Description: The specimen is an elliptic piece of tan pink to red skin, measuring 7.8 x 3.9 cm, with a depth of up to 2.6 cm.
0:00:46 Lesion Characteristics: A central 6.3 x 2.5 cm tan pink to red, ulcerative, and poorly demarcated area is present.
0:01:15 Margin Clearances: The closest margins are measured:
0:01:48 Specimen Orientation: A short stitch is placed at 12:00 (superior) and a long stitch at 9:00 (medial).
0:01:57 Deep Aspect: The deep surface is tan brown to yellow, scabrous, with moderate attached muscle and fascia.
0:02:08 Inking Protocol: The 12:00 aspect is inked blue, the 6:00 aspect is inked black, and the deep aspect is inked orange.
0:02:49 Radial Margin Removal: The radial resection margin is removed sequentially and submitted en face in a clockwise fashion, starting from 12:00 superior to 11:00 superior.
0:03:27 Internal Findings: Serial sectioning reveals a tan yellow, granular cut surface that extends to the underlying muscle and subcutaneous fat layers.
0:04:06 Deep Margin Measurement: The granular cut surface is 0.6 cm from the closest deep resection margin.